NHS Complaints which also include Local Authorities

These may be

• complaints which from the outset cover several areas, some of which are NHS responsibility while others are the responsibility of the Local Authority, e.g. multi-disciplinary team working
• complaints which start off as being about one organisation but investigations reveal possible failings by another, e.g. hospital discharge arrangements but arise from that organisation’s decision not to accept an assessment/recommendations of the other, e.g. continuing care.
• when a complaint is about the services of both agencies, or about a jointly managed service, under a “partnership agreement” and both complaints systems apply.

The amended regulations provides that, where the complainant so wishes, the organisations involved must co-operate to deal with the part of the complaint that relates to them and provide a co-ordinated response to the complaint.

On receipt of a complaint, the NHS body should check whether it appears also to raise issues around local authority handling of the case. If so, within 10 working days of receiving the complaint, it must seek to obtain the consent of the complainant to sending details of the complaint to the local authority. Where the complainant does not want the details to be shared, the NHS body should advise them on the parts of the complaint it is able to deal with, adding that if the complainant wants to pursue the social services part of the complaint, they should approach the relevant local authority.

Where the complainant wants the details to be shared, the local authority must deal with its part of the complaint under the Social Services Regulations and cooperate with the NHS body that received the complaint to resolve the entire complaint and provide a co-ordinated response.

The NHS body that received the complaint is also bound by a duty to co-operate with the local authority in resolving the complaint.
The duty to cooperate for all parties includes the duty to:

• share relevant information, and
• attend joint meetings reasonably arranged to consider the complaint.

Additionally, the two bodies should seek to agree which organisation should take the lead in co-ordinating the handling of the complaint and dealing with the complainant. The lead body’s Complaints Manager must:

• coordinate the handling of the complaint by working closely with all those involved,
• ensure a comprehensive and appropriate response is sent, and
• ensure that they keep the complainant informed and, where possible, coordinate a single reply.

The protocols for determining the lead agency are best worked out locally (see paragraph 3.15). However, regulation 13(2) of the Principal Regulations provides that the Chief Executive of the NHS body should sign the response, except where there are good reasons for them not being able to do so. Irrespective of ‘lead’ responsibility, each body retains its duty of care to the complainant and must handle its part of the complaint in accordance with its own regulated procedures. The Social Services Regulations have a provision that mirrors the new regulation 3A to ensure that this can occur.

Joint handling of a case should not affect the need to meet statutory deadlines for providing a response to the complainant and both agencies should seek to avoid any unnecessary delay. Fostering a culture of effective joint working will greatly aid this requirement. The NHS body and the Local Authority should consider a joint meeting with the complainant if this will facilitate a more effective outcome.

Close cooperation between Complaints Managers should help identify which issues should be referred to the appropriate Body, should the complainant wish to go forward to independent review. The coordinated response must identify which parts relate to the relevant aspects of the complaint letter. This will be of great assistance to an independent body that might subsequently have to review the complaint. The response should advise the complainant of their right to pursue the complaint further and provide details of which regulatory organisation would deal with each aspect of the complaint.

Where services are provided in a ‘package’, but delivered by separate bodies (e.g. some by NHS and some by a Local Authority), the lead Complaints Manager should still ensure that all aspects of the complaint are investigated by the appropriate body, and that the complainant is kept informed of the progress of the complaint and who is involved.

NHS Complaints Managers receiving complaints relating partly to Local Authority services may wish to see Section 7.5 of ‘Learning from Complaints ’ (Guidance for Social Services Adult Services complaints).

Complaints Managers should also be aware of the need to work with other procedures that have a significant bearing on the complaints procedures, such as child protection and protection of vulnerable adults.

Complaints made to an NHS body relating only to a local authority

There are occasions where an NHS body will receive a complaint about the actions of a local authority. This can happen where the complainant does not understand which organisation is responsible for which service. However, in some cases it might be an important issue of trust – someone might, for example, speak to a social worker they trust about his concerns over NHS treatment, or approach a District Nurse about a carer employed by the Local Authority.

The NHS body must –
(a) within 5 working days of the receipt of the complaint, ask the complainant whether he wishes that material to be sent to the local authority to which it relates; and
(b) if the complainant does so wish, send that material to that local authority as soon as reasonably practical.

Where a complainant is referred to a local authority the complainant shall be deemed to have made a complaint under regulation 3 of the Social Care Complaints regulations (making a complaint) for the purposes of those Regulations.

There are occasions where complaints received by a NHS body may also involve services provided by another body, for example, a matter relating to detention under the Mental Health Act. Where this happens, people who use such services should not have to worry about whom to approach with complaints about different aspects of their care and the service that they receive. NHS bodies should advise complainants which matters fall under which procedure.

For example, where complaints are made that might relate in part to a matter for the Mental Health Act Commission procedures, NHS bodies should advise the complainant of the ability to complain to the MHAC.

Where a complaint involves more than one NHS provider, NHS bodies should seek to resolve the complaint through each body’s local complaints procedure in a cooperative manner.

It is important to note that the procedures in the new regulation 3A apply only to complaints involving NHS bodies and local authorities. However, it is good practice that all bodies involved in delivering health and social care should work together to respond to complaints and comments about their services.

NHS bodies may receive written complaints that are solely concerned with areas properly dealt with by another health body or by a body outside the NHS – although those involving a local authority should be dealt with as set out above. In these cases, the complaints manager should resolve any doubts or disagreements over which body is responsible for handling the complaint. The Complaints Manager should then ask the complainant whether they wish the complaint to be forwarded directly to the relevant body. The name of this body should be included in the letter. If the claimant agrees, the complaint should be forwarded as soon as possible. This decision, and the action taken, should be recorded in writing.

Next: Commission for Social Care Inspection (CSCI)